What is Enantyum for?

Baptized with the generic name of monstrous and unpronounceable dexketoprofen! the Enantyum is another of the painkillers that go about their respects in our medical kits. Younger (and perhaps less well known) than the Vénue or Nolotil, he has been with us for twenty years and it is worth knowing him a little more in depth.

What is enantyum or dexketoprofen for?

Unlike other painkillers such as paracetamol or ibuprofen, which serve the same purpose as a broken one, the Enantyum is used mainly in these specific circumstances:

- Musculoskeletal pain: like the one originated by lumbago or traumatisms (blows, accidents).

- Dysmenorrhea: pain of a rule.

- Toothache: it is frequently prescribed by dentists for toothaches and the like.

The first conclusion to be drawn is that Enantyum is not the drug of choice for a headache.

How does dexketoprofen work?

It is a NSAID (non-steroidal anti-inflammatory) and as such inhibits nonspecifically the two isoenzymes of cyclooxygenase (COX-1 and COX-2). It is the same mechanism of action that I already explained in the post how ibuprofen knows where it has to act. For those of you who are curious, it is worth watching this video:

How should it be taken?

It is up to the doctor to set the standard, but in general, 25 mg tablets are usually given every 8 hours.

Is it suitable for children?

Another difference with paracetamol and ibuprofen (that of Dalsy or Apiretal) is that there are no clinical studies of Enantyum in small creatures and therefore should not be used in children and adolescents.

Does Enantyum have any side effects?

As a good NSAID, it presents the popular classics of the family: gastrolesivity (that which damages the stomach) and cardiovascular risk in certain subjects and at certain doses, as jumped to the media to scare everyone last spring.

In this document of the SEFH are ordered from major to minor anti-inflammatory according to the aggressiveness to the stomach.

As we see, the Enantyum does not make a podium among the most "dangerous" but wins his Olympic diploma with the fourth place being more gastrolesivo than Aspirin, Voltaren or Ibuprofen.

To minimize the damage to the stomach, it is advisable to take it with food or with anti-ulcers such as omeprazole if it is a prolonged consumption.

Can dexketoprofen be applied topically?

Like diclofenac and its gel version (Voltadol or Voltadol Forte), dexketoprofen is available in gel form as Enangel, Ketesgel or Quirgel. It is also related to the well-known Fastum gel (ketoprofen). The difference with Voltadol or Voltadol Forte, which are over-the-counter medications, is that all of these topical formulations require medical prescription.

It is used in joints, muscles, tendons, and ligaments when there are traumatic and painful or phlogistic affections. Flogistics, which we know, does not mean that they are loose, but inflammatory, conditions. It all comes from the Theory of Phlogiston (postulated by the Germans Becher and Stahl in the seventeenth century) by which it was considered that all the elements that could enter into combustion (inflamed) contained a common substance called phlogiston. A century later Lavoisier's spoof would arrive to explain that that of the phlogiston had neither feet nor head. The phlogiston was nice while it lasted.

Returning to the more prosaic side of anti-inflammatory gels, it is important to note that they are photosensitizing drugs. Its use should be assessed in patients with a history of photoallergic reactions and use appropriate photoprotection measures. This 2010 AEMPS alert places particular emphasis on this.

If all are anti-inflammatory, is Enantyum or ibuprofen better?

There are several reviews (the links are at the end of the post) that show an efficacy of oral Enantym for dental, postoperative or musculoskeletal pain similar to that of metamizole, diclofenac or ibuprofen. The advantage of Enantyum is that it shows a greater speed of action.

This study indicates that after oral surgery, ibuprofen takes longer to effect than dexketoprofen although its analgesic duration is longer (six to eight hours versus five and a half).

At the hospital level, injectable dexketoprofen is also considered a great analgesic alternative to Nolotil or Voltaren. In postoperative pain, the onset of action is also faster and combined with opioids allows to avoid the administration of morphine between 35 and 45%. This Cochrane review indicates that with a single dose of dexketoprofen from 10 mg to 25 mg a high level of pain relief is obtained, between 45% and 50%, in patients with moderate to severe postoperative pain.

The Council of the Apothecary

By way of summary, Enantyum or dexketoprofen is an NSAID that is used primarily for musculoskeletal and dental pain. It is as effective as other analgesics although faster than ibuprofen. It should not be used without a prescription.

And taking advantage of the fact that the Pisuerga passes through Valladolid, and that this issue falls within one of my particular wars, I would like to remind you that for mild and moderate headaches, it is always better to use the 400 mg ibuprofen dose than 600 mg.